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GS Medbear > Breast > Flashcards

Breast Flashcards

1
Q

Commonest cause of bloody nipple discharge in pts 20-40yo?

A

Intraductal papilloma

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2
Q

Triple assessment to exclude CA from fibrocystic change?

A

Hx & Clinical exam
Imaging
Histopathological assessment (biopsy)

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3
Q

Hormonal factors for breast CA?

A

Early menarche <12yrs
Late menopause >55yo
Late 1st childbirth
Hormone replacement therapy
Nulliparity

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4
Q

Blood stain/spot on bra?

A

Paget’s or Dermatitis/Eczema

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5
Q

Fibroadenomas arise from?

A

terminal duct lobular units

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6
Q

Breast infection divided into?

A

Lactational or non-lactational infection

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7
Q

Causes of microcal in mammograms?

A

DCIS
Invasive CA
Fibrocystic disease
Papilloma

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8
Q

Defining feature of microcal for diagnosis?

A

Microcals in straight line = DCIS
Scattered Microcals = Fibrocystic disease

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9
Q

Cause of stellate lesion with poor outline or comet sign?

A

Invasive CA, radial scar (benign), fat necrosis, abscess

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10
Q

1st investigation for young pts <35 and pregnant/lactating pts?

A

Ultrasound.
Cuz they have denser breasts hence easier to evaluate with US than MMG

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11
Q

DCIS definition?

A

Malignancy from terminal dut-lobular unit. Preserves myoepithelial cell layer.
PRE-INVASIVE BREAST CA

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12
Q

Paget’s associated with?

A

Underlying DCIS or invasive CA in 85-88% of cases.

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13
Q

Level 3 axillary LNs are where?

A

Medial to pec minor

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14
Q

Level 2 axillary LNs where?

A

Posterior to Pec minor

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15
Q

Level 1 axillary LNs where?

A

Lateral of Pec minor

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16
Q

Fibrocystic Changes of breast?

A

Cysts & Apocrine metaplasia
Epithelial hyperplasia
Fibrosis
Adenosis

17
Q

Features of Fibroadenoma?

A

Firm well defined mobile tumour, slow growing

18
Q

Milk discharge 1 year after stopping breastfeeding. Isit normal?

A

No

19
Q

Brownish discharge suggests?

A

Ductal ectasia

20
Q

Bloody discharge should be investigated via?

A

MMG, US, FNAC

21
Q

Which growth cannot be seen on MMG?

A

Papilloma. Too small. Can cause nipple retraction

22
Q

Green / Black / Brown nipple discharge means?

A

Mammary ductal ectasia. Due to cell debris

23
Q

Who gets puerperal abscesses?

A

Primiparous mothers

24
Q

Who gets non-puerperal abscesses?

A

Commonest non-breastfeeding abscess. Seen in young women, esp smokers

25
Q

Treatment for mammary ductal ectasia?

A

None, usu self-limiting

26
Q

Fibroadenoma?

A

Common in young women.
Sometimes regress spontaneously

27
Q

What raises risk of breast CA?

A

Higher estrogen exposure:
Early menarche, OCP, late 1st pregnancy, nulliparity, late menopause, white ethnicity etc.

28
Q

How to differentiate breast abscess and mastitis?

A

Breast abscess is fluctuant, mastitis is not

29
Q

Breast CA screening?

A

40-49 every year
50 and above every 2 years

30
Q

What drug for endocrine hormone therapy for early breast cancer?

A

Tamoxifen.
Estrogen receptor is a good predictive marker for response to endocrine therapy

31
Q

How often to screen for cervical cancer?

A

25-29yo every 3 years
>30 years, every 5 years

32
Q

Mammogram screening guidelines?

A

Yearly from 40-49 years.
Biannually from 50 onwards

33
Q

Why screen yearly for mammogram from 40-49 years?

A

Breast tissue is denser at 40-49 compared to > 50 years.
Hence it is less specific and sensitive. Hence want to screen more often to be safe.
Actually 40-49 years dont rly have to screen unless got risk factors.

25% of breast cancers can be missed through mammogram at 40-49 years

34
Q

How to screen for breast stuff below 40 years?

A

Do ultrasound straightaway.
Breast tissue is too dense to evaluate with mammogram

GS Medbear (14 decks)

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